Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiac > Valvular Heart Disease > Flashcards

Valvular Heart Disease Flashcards

1
Q

What causes S1 sound?

A

Closure of mitral and tricuspid valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What causes S2 sound?

A

Closure of aortic and pulmonic valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What might an S3 heart sound suggest?

A

Congestive heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What might an S4 heart sound suggest?

A

Poor ventricular compliance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Location for auscultating aortic valve sounds?

A

Right sternal border at 2nd intercostal space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Location for auscultating pulmonic valve sounds

A

Left sternal border at 2nd intercostal space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Location for auscultating mitral valve sounds

A

Left midclavicular line at 5th intercostal space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Location for auscultating tricuspid valve sounds

A

Left sternal border at 4th intercostal space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Heart sound that marks onset of systole

A

S1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Heart sound that marks the onset of diastole

A

S2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Heart sound that marks beginning of isovolumic contraction

A

S1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Heart sound that marks beginning of isovolumic relaxation

A

S2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Heart sound is louder with vigorously contracting ventricle

A

S1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Heart sound is softer with poorly contracting ventricle

A

S1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Heart sound is louder with hypertension

A

S2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Heart sound is softer with hypotension

A

S2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When is S3 heard?

A

During middle 1/3 of diastole- after S2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What causes S4 heart sound?

A

Atrial systole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When is S4 heard?

A

Before S1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What part of the stethoscope is best for listening to high pitched sounds (S1, S2, regurgitation)?

A

Diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What part of the stethoscope is best for listening to low pitched sounds (S3, S4, mitral stenosis)?

A

Bell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What type of valvular lesion results in concentric hypertrophy?

A

Stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Valvular, fixed obstruction to forward flow

A

Stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Valvular lesion- turbulent blood flow, higher velocity of travel

A

Stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Cardiac compensation in which sarcomeres are added in a parallel fashion and the wall chamber becomes thicker > reduces chamber radius

A

Concentric hypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Incompetent valve

A

Regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Valvular lesion- some blood flows forward and some blood flows backward

A

Regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Valvular lesion- volume overload

A

Regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Heart compensates by adding sarcomere in series > chamber radius increases

A

Eccentric hypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Normal aortic valve area

A

2.5- 3.5 cm2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Aortic valve area in severe aortic stenosis

A

≤0.8 cm2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Etiologies of aortic stenosis

A

Bicuspid aortic valve
Rheumatic fever
Infective endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Compensatory mechanisms of aortic stenosis

A

Increased thickness of the left ventricular wall
Decreased compliance
Smaller chamber radius

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Presentation of aortic stenosis

A

Syncope
Angina
Dyspnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Anesthetic goals for aortic stenosis

A

HR: Avoid tachycardia
Rhythm: NSR (maintain atrial kick)
Preload: Increase
Afterload: Maintain or increase
Contractility: Maintain
Pulmonary vascular resistance: Normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Anesthetic considerations for aortic stenosis

A

Avoid spinal anesthesia in patients with severe aortic stenosis

Chest compressions often ineffective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Arterial waveform of aortic stenosis

A

May show:
Pulsus tardus
Pulsus parvus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Transvalvular pressure gradient in aortic stenosis

A

> 40 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Wall tension in aortic stenosis (increased or decreased)

A

Increased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

EDV and ESV in aortic stenosis (increased or decreased)

41
Q

What valvular lesion does the pressure volume loop represent?

A

Aortic stenosis

42
Q

What is pulsus tardus?

A

Slower systolic upstroke on arterial waveform

43
Q

What is pulsus parvus?

A

Narrow pulse pressure with small amplitude waveform on arterial line tracing

44
Q

Effects of aortic insufficiency on the left ventricle

A

Volume overload
Eventual eccentric hypertrophy

45
Q

Etiologies of aortic regurgitation

A

Incompetent valve
Dilation of the aortic root/ supporting structures

46
Q

What conditions should be avoided in aortic regurgitation?

A

Bradycardia
Increased SVR
Large valve orifice

47
Q

How is cardiopulmonary bypass approach different in patients with aortic regurgitation?

A

Cardioplegia must be injected retrograde (through coronary sinus) or directly into each coronary ostia

48
Q

What are causes of acute aortic insufficiency?

A

Endocarditis (most common)

Aortic root dissection from aneurysm or trauma

49
Q

What is the pathophysiology of acute aortic insufficiency?

A

LV becomes acutely dilated > increased wall tension > LV failure > rapid cardiovascular instability

50
Q

What conditions are associated with aortic insufficiency?

A

Valvular calcification
Marfan syndrome
Ehler-Danlos syndrome
Ankylosing spondylitis

51
Q

Heart rate goal for aortic insufficiency

52
Q

Preload goal for aortic insufficiency

A

Maintain/ increase

53
Q

Contractility goal for aortic insufficiency

54
Q

SVR goal for aortic insufficiency

55
Q

Pulmonary vascular resistance goal for aortic insufficiency

56
Q

What valvular lesion is associated with a sharp upstroke, low diastolic pressure, and wide pulse pressure on the arterial waveform?

A

Aortic insufficiency

57
Q

What valvular lesion may have this arterial waveform tracing?

A

Aortic insufficiency

58
Q

What valvular lesion may have this arterial waveform tracing?

A

Aortic stenosis

59
Q

What valvular lesion does the pressure volume loop represent?

A

Chronic aortic regurgitation

60
Q

What valvular lesion does the pressure volume loop represent?

A

Mitral stenosis

61
Q

Normal area of the mitral valve orifice

62
Q

Area of mitral valve orifice in severe mitral stenosis

63
Q

Quantitative indications of severe mitral stenosis

A

Transvalvular pressure gradient >10 mmHg

Pulmonary artery systolic pressure >50 mmHg

64
Q

Most common causes of mitral stenosis

A

Rheumatic fever (developing nations)

Endocarditis (United States)

Calcification of the mitral annulus secondary to atherosclerosis (United States)

65
Q

Etiologies of mitral stenosis

A

Rheumatic fever

Endocarditis

Calcification of the mitral annulus secondary to atherosclerosis

Rheumatic arthritis

Systemic lupus erythematosus

Congenital defect

Left atrial myxoma

Carcinoid syndrome

Iatrogenic following mitral valve repair

66
Q

What valvular lesion does the pressure volume loop represent?

A

Mitral stenosis

67
Q

The image depicts the pathophysiology of which valvular lesion

A

Mitral stenosis

68
Q

Heart rate goal for mitral stenosis

A

Slower end of normal

69
Q

Preload goal for mitral stenosis

70
Q

Contractility goal for mitral stenosis

71
Q

SVR goal for mitral stenosis

72
Q

Pulmonary vascular resistance goal for mitral stenosis

A

Avoid increase

73
Q

Regional anesthesia considerations for mitral stenosis

A

Pts are prone to atrial fibrillation and may be anticoagulated. Avoid neuraxial anesthesia in pts with INR >1.5

74
Q

What valvular lesion does the pressure volume loop represent?

A

Chronic mitral regurgitation

75
Q

The image depicts the pathophysiology of which valvular lesion

A

Mitral regurgitation

76
Q

Etiologies of mitral insufficiency

A

Rheumatic fever
Ishcemic heart disease
Papillary muscle dysfunction
Ruptured chordae tendineae
Endocarditis
Mitral valve prolapse
Left ventricular hypertrophy
Systemic lupus erythematosus
Rheumatoid arthritis
Carcinoid syndrome

77
Q

Mitral insufficiency results in:

A

Volume overload
Eccentric hypertrophy (left atrium)

78
Q

Conditions to avoid in mitral insufficiency

A

Slow heart rate

Increased pressure gradient between the LV and LA

Increased SVR

Increased size of valve orifice

79
Q

Heart rate goal in mitral insufficiency

A

Increased (NSR)

80
Q

Preload goal in mitral insufficiency

A

Maintain or increase

81
Q

Contractility goal in mitral insufficiency

82
Q

SVR goal in mitral insufficiency

83
Q

Pulmonary vascular resistance goal in mitral insufficiency

A

Avoid increase

84
Q

Systolic murmurs

A

Aortic stenosis
Mitral regurgitation

85
Q

Diastolic murmurs

A

Aortic regurgitation
Mitral stenosis

86
Q

Characteristics of aortic stenosis assessment

A

Auscultated at right sternal border through aorta and carotid arteries

May be confused with bruit

May be palpated as a thrill

May decrease with severity

87
Q

Characteristics of aortic regurgitation assessment

A

High pitch blowing murmur

Auscultated at right sternal border

88
Q

Characteristics of mitral stenosis assessment

A

Opening snap followed by low intensity rumbling murmur

Auscultated at the apex and left axilla

89
Q

Characteristics of mitral regurgitation assessment

A

Holosystolic murmur- loud swishing sound

Auscultated at apex and left axilla

90
Q

The three surgical approaches for transcatheter aortic valve replacement

A

Transfemoral
Transaortic
Transapical (antegrade)

91
Q

Benefits of transcatheter aortic valve replacement

A

Sternotomy not required
Cardiopulmonary bypass not required

92
Q

Most common valves used for transcatheter aortic valve replacement

A

Edwards SAPIAN
Medtronic CoreValve

93
Q

Type of artificial valve that requires balloon valvulosplasty

94
Q

Type of artificial valve that requires rapid ventricular pacing

95
Q

Considerations for rapid ventricular pacing

A

Profound hypotension during pacing

Ensure MAP >75 mmHg before pacing

Have radiotranslucent pads on pt prior to pacing

Keep pt apneic during pacing

96
Q

Self-expanding artificial valve

97
Q

Improper artificial valve deployment symptom

A

Acute aortic insufficiency

98
Q

Surgical treatment for improper artificial valve deployment

A

SAPIAN- place another SAPIAN valve through malpositioned valve (valve-in-valve procedure)

CoreValve- retrieve and redeploy

99
Q

Complications fo transcatheter aortic valve replacement

A

Vascular injury (hemorrhage)

Coronary occlusion

Annular rupture (cardiac tamponade> cardiovascular collapse)

Stroke

Perivalvular leak

Pericardial tamponade

AV block

LBBB

3rd degree block if pt has preexisting RBBB

Cardiac (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions